Christian-H Heeger, Leonie Zetzsch, Charlotte Eitel, Jan-Per Wenzel, Sorin Ștefan Popescu, Henning Rolfes, Sascha Hatahet, Behnam Subin, Karl-Heinz Kuck, Roland R Tilz
{"title":"基于脉冲场消融的肺静脉分离采用简化方法或标准方法-来自快速和激烈的PFA研究的见解。","authors":"Christian-H Heeger, Leonie Zetzsch, Charlotte Eitel, Jan-Per Wenzel, Sorin Ștefan Popescu, Henning Rolfes, Sascha Hatahet, Behnam Subin, Karl-Heinz Kuck, Roland R Tilz","doi":"10.1007/s10840-025-02046-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pulsed field ablation (PFA) is a novel non-thermal energy source. Recently, we developed a tailored and streamlined pulmonary vein isolation (PVI) approach utilizing a pentaspline PFA catheter via a single access, single catheter approach. This study was aimed at comparing safety, efficacy, and follow-up of this approach with a conventional approach.</p><p><strong>Methods and results: </strong>Fifty consecutive patients with atrial fibrillation (AF) underwent first-time PVI via PFA under deep sedation. The first 25 patients were treated with a conventional approach utilizing two femoral vein access sheath inclusive utilization of 3D mapping and a coronary sinus catheter (conventional approach, control group). The second 25 patients were treated via a simplified single venous, single transseptal puncture, single catheter approach utilizing a vascular closure system (Fast and Furious PFA approach, FAST group). A total of 194 PVs were identified and isolated with PFA only (100%). The median procedural time was 26 (25, 30) min (FAST) and 65 (59, 72) min (control), respectively (P < 0.0001). The median fluoroscopy time was 5 (4, 7) min (FAST) and 12 (10, 14) min (control), respectively (P < 0.001). Freedom from AF recurrence at 12 months was 77% for the FAST group (vs.</p><p><strong>Control: </strong>81%, P = 0.856, and overall: 79%).</p><p><strong>Conclusion: </strong>The combination of a single venous puncture, single transseptal puncture approach utilizing PFA and vascular closure device resulted in a 100% rate of acute PVI and fast procedure with comparable safety, acute efficacy and 12-month outcome to the conventional approach.</p>","PeriodicalId":16202,"journal":{"name":"Journal of Interventional Cardiac Electrophysiology","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pulsed field ablation-based pulmonary vein isolation utilizing a simplified approach or a standard approach-insights from the fast and furious PFA study.\",\"authors\":\"Christian-H Heeger, Leonie Zetzsch, Charlotte Eitel, Jan-Per Wenzel, Sorin Ștefan Popescu, Henning Rolfes, Sascha Hatahet, Behnam Subin, Karl-Heinz Kuck, Roland R Tilz\",\"doi\":\"10.1007/s10840-025-02046-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Pulsed field ablation (PFA) is a novel non-thermal energy source. Recently, we developed a tailored and streamlined pulmonary vein isolation (PVI) approach utilizing a pentaspline PFA catheter via a single access, single catheter approach. This study was aimed at comparing safety, efficacy, and follow-up of this approach with a conventional approach.</p><p><strong>Methods and results: </strong>Fifty consecutive patients with atrial fibrillation (AF) underwent first-time PVI via PFA under deep sedation. The first 25 patients were treated with a conventional approach utilizing two femoral vein access sheath inclusive utilization of 3D mapping and a coronary sinus catheter (conventional approach, control group). The second 25 patients were treated via a simplified single venous, single transseptal puncture, single catheter approach utilizing a vascular closure system (Fast and Furious PFA approach, FAST group). A total of 194 PVs were identified and isolated with PFA only (100%). The median procedural time was 26 (25, 30) min (FAST) and 65 (59, 72) min (control), respectively (P < 0.0001). The median fluoroscopy time was 5 (4, 7) min (FAST) and 12 (10, 14) min (control), respectively (P < 0.001). Freedom from AF recurrence at 12 months was 77% for the FAST group (vs.</p><p><strong>Control: </strong>81%, P = 0.856, and overall: 79%).</p><p><strong>Conclusion: </strong>The combination of a single venous puncture, single transseptal puncture approach utilizing PFA and vascular closure device resulted in a 100% rate of acute PVI and fast procedure with comparable safety, acute efficacy and 12-month outcome to the conventional approach.</p>\",\"PeriodicalId\":16202,\"journal\":{\"name\":\"Journal of Interventional Cardiac Electrophysiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-04-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Interventional Cardiac Electrophysiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10840-025-02046-3\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Interventional Cardiac Electrophysiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10840-025-02046-3","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Pulsed field ablation-based pulmonary vein isolation utilizing a simplified approach or a standard approach-insights from the fast and furious PFA study.
Background: Pulsed field ablation (PFA) is a novel non-thermal energy source. Recently, we developed a tailored and streamlined pulmonary vein isolation (PVI) approach utilizing a pentaspline PFA catheter via a single access, single catheter approach. This study was aimed at comparing safety, efficacy, and follow-up of this approach with a conventional approach.
Methods and results: Fifty consecutive patients with atrial fibrillation (AF) underwent first-time PVI via PFA under deep sedation. The first 25 patients were treated with a conventional approach utilizing two femoral vein access sheath inclusive utilization of 3D mapping and a coronary sinus catheter (conventional approach, control group). The second 25 patients were treated via a simplified single venous, single transseptal puncture, single catheter approach utilizing a vascular closure system (Fast and Furious PFA approach, FAST group). A total of 194 PVs were identified and isolated with PFA only (100%). The median procedural time was 26 (25, 30) min (FAST) and 65 (59, 72) min (control), respectively (P < 0.0001). The median fluoroscopy time was 5 (4, 7) min (FAST) and 12 (10, 14) min (control), respectively (P < 0.001). Freedom from AF recurrence at 12 months was 77% for the FAST group (vs.
Control: 81%, P = 0.856, and overall: 79%).
Conclusion: The combination of a single venous puncture, single transseptal puncture approach utilizing PFA and vascular closure device resulted in a 100% rate of acute PVI and fast procedure with comparable safety, acute efficacy and 12-month outcome to the conventional approach.
期刊介绍：
The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.
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